619 research outputs found
Parental child-feeding strategies in relation to Dutch children's fruit and vegetable intake
Objective: To identify parental child-feeding strategies that may increase children's fruit or vegetable intake, since the relationship between these strategies and children's intake has never been investigated for fruit and vegetables as two separate food groups. Design: A survey study, where parents provided information about their practices in relation to feeding their children and about their own and their children's fruit and vegetable intake. Children completed a preference questionnaire about fruit and vegetables. To find underlying parental child-feeding strategies, factor analysis was applied to parents' practices in relation to fruit and vegetables separately. Regression analysis was used to predict the effect of these strategies on children's fruit and vegetable intake. The impact of the strategies was further analysed by estimating children's intake based on the frequency of use of specific strategies. Setting: The study was conducted at three primary schools in The Netherlands. Subjects: A total of 259 children between 4 and 12 years old and their parents (n242). Results: Parents used different strategies for fruit as compared with vegetables. The vegetable-eating context was more negative than the fruit-eating context. Parental intake and presenting the children with choice were positive predictors of children's intake of both fruit and vegetables. The intake difference based on frequency of use of the strategy 'Choice' was 40 g/d for vegetables and 72 g/d for fruit (
Computed tomography coronary angiography : from quantification of coronary atherosclerosis to risk stratification of patients
The objective of this dissertation was to establish the value of QCT to further enhance the clinical applicability and accuracy of coronary CTA. The automatic characterization of coronary atherosclerosis with QCT is feasible and correlates well with IVUS VH. Secondly, novel CTA risk score was created incorporating detailed information on the location, severity and composition of atherosclerosis as assessed with QCT. This CTA risk score allows accurate risk stratification of patients with suspected CAD. A drawback of coronary CTA is the fact that the hemodynamic significance of a lesion cannot be evaluated. In this thesis it was demonstrated that QCT provided better correlation with the presence of myocardial ischemia on SPECT MPI as compared to current visual assessment of coronary CTA.
With regards to the specific setting of high risk diabetic patients without chest pain syndrome several conclusion can be derived from this thesis. First, if treated with optimal medical therapy, very few patients present with progression of myocardial ischemia. Second, the prognosis of these patients is good; the overall long-term event-rate is limited. Especially diabetic patients without CAD on coronary CTA have an excellent prognosis.
LUMC / Geneeskund
Breve análisis de los factores que intervienen en el aprendizaje ortográfico
Si revisamos el rendimiento escolar de nuestros alumnos referido a la
lengua escrita comprobaremos cómo uno de los problemas que frecuentemente
se nos plantea, además de la alarmante pobreza de vocabulario y la precariedad
de la expresión, son las faltas de ortografía. Ello se debe a la complejidad
de los factores que intervienen en el proceso escritor donde está implicada esta
disciplina lingüística. En este artículo estudiamos cada uno de estos elementos
que, a nuestro juicio, deben considerarse al analizar el fracaso ortográfico de
nuestros estudiantes.If we reexamine our students school efficiency relating written language,
we will verify that one of the problems that we usually find, besides the alarming
vocabulary poverty and the precarious expression, are orthographic mistakes.
This fact is due to the complexity of the writing process factors where this
linguistic discipline is implicated. In the present paper we specify every one of
these elements that we must be considered on analysing the wrong spelling of
our students.Facultad de Educación y Humanidades - Campus de Melilla (Universidad de Granada
Co-designing a social robot for child health care
Social robots provide new opportunities to support general child healthcare programs. However, it is still unclear how social robots could be used in this context and how corresponding behaviours should be designed. To ensure satisfying implementations of such new technological solutions, it is essential to include the end-users in the designing process. We have conducted a co-design study at two primary schools based on three complementary, creative methods: Draw-write-and-tell and/or story-writing-and-telling, Theatre play, and Robot avatar programming. A total of 46 children aged 7–12 years old participated in four robot co-design workshops. The drawings, stories and theatre plays were analysed, resulting in evaluations of 10 scenarios as well as 21 new scenarios and 7 main user requirements for social robots providing mental support in general child healthcare. Evaluation of the activities highlight their stimulation of out-of-the-box thinking and the development of creative solutions (i.e. drawings/stories/theatre plays resulted in robot designs, scenarios and requirements), while children's reflections show them being enjoyable for participation. The inputs gathered during these co-design workshops will greatly influence future work on the design and application of social robots in the child healthcare domain
The Sum of lts Parts-Effects of Gastric Distention, Nutrient Content and Sensory Stimulation on Brain Activation
During food consumption the brain integrates multiple interrelated neural and hormonal signals involved in the regulation of food intake. Factors influencing the decision to stop eating include the foods' sensory properties, macronutrient content, and volume, which in turn affect gastric distention and appetite hormone responses. So far, the contributions of gastric distention and oral stimulation by food on brain activation have not been studied. The primary objective of this study was to assess the effect of gastric distention with an intra-gastric load and the additional effect of oral stimulation on brain activity after food administration. Our secondary objective was to study the correlations between hormone responses and appetite-related ratings and brain activation. Fourteen men completed three functional magnetic resonance imaging sessions during which they either received a naso-gastric infusion of water (stomach distention), naso-gastric infusion of chocolate milk (stomach distention + nutrients), or ingested chocolate-milk (stomach distention + nutrients + oral exposure). Appetite ratings and blood parameters were measured at several time points. During gastric infusion, brain activation was observed in the midbrain, amygdala, hypothalamus, and hippocampus for both chocolate milk and water, i.e., irrespective of nutrient content. The thalamus, amygdala, putamen and precuneus were activated more after ingestion than after gastric infusion of chocolate milk, whereas infusion evoked greater activation in the hippocampus and anterior cingulate. Moreover, areas involved in gustation and reward were activated more after oral stimulation. Only insulin responses following naso-gastric infusion of chocolate milk correlated with brain activation, namely in the putamen and insula. In conclusion, we show that normal (oral) food ingestion evokes greater activation than gastric infusion in stomach distention and food intake-related brain areas. This provides neural evidence for the importance of sensory stimulation in the process of satiation
Exploring patients’ experience using PROMs within routine post-discharge follow-up assessment after stroke:a mixed methods approach
Background: Patient Reported Outcomes Measures (PROMs) are being used increasingly to measure health problems in stroke clinical practice. However, the implementation of these PROMs in routine stroke care is still in its infancy. To understand the value of PROMs used in ischemic stroke care, we explored the patients’ experience with PROMs and with the consultation at routine post-discharge follow-up after stroke. Methods: In this prospective mixed methods study, patients with ischemic stroke completed an evaluation questionnaire about the use of PROMs and about their consultation in two Dutch hospitals. Additionally, telephone interviews were held to gain in-depth information about their experience with PROMs. Results: In total, 63 patients completed the evaluation questionnaire of which 10 patients were also interviewed. Most patients (82.2–96.6%) found completing the PROMs to be feasible and relevant. Half the patients (49.2–51.6%) considered the PROMs useful for the consultation and most patients (87.3–96.8%) reported the consultation as a positive experience. Completing the PROMs provided 51.6% of the patients with insight into their stroke-related problems. Almost 75% of the patients found the PROMs useful in giving the healthcare provider greater insight, and 60% reported discussing the PROM results during the consultation. Interviewed patients reported the added value of PROMs, particularly when arranging further care, in gaining a broader insight into the problems, and in ensuring all important topics were discussed during the consultation. Conclusions: Completing PROMs appears to be feasible for patients with stroke attending post-discharge consultation; the vast majority of patients experienced added value for themselves or the healthcare provider. We recommend that healthcare providers discuss the PROM results with their patients to improve the value of PROMs for the patient. This could also improve the willingness to complete PROMs in the future.</p
The longitudinal association between movement behavior patterns and the course of participation up to one year after stroke
Purpose: (1) To investigate the differences in the course of participation up to one year after stroke between distinct movement behavior patterns identified directly after discharge to the home setting, and (2) to investigate the longitudinal association between the development of movement behavior patterns over time and participation after stroke.Materials and methods: 200 individuals with a first-ever stroke were assessed directly after discharge to the home setting, at six months and at one year. The Participation domain of the Stroke Impact Scale 3.0 was used to measure participation. Movement behavior was objectified using accelerometry for 14 days. Participants were categorized into three distinct movement behavior patterns: sedentary exercisers, sedentary movers and sedentary prolongers. Generalized estimating equations (GEE) were performed.Results: People who were classified as sedentary prolongers directly after discharge was associated with a worse course of participation up to one year after stroke. The development of sedentary prolongers over time was also associated with worse participation compared to sedentary exercisers.Conclusions: The course of participation after stroke differs across distinct movement behavior patterns after discharge to the home setting. Highly sedentary and inactive people with stroke are at risk for restrictions in participation over time.Implications for rehabilitation: The course of participation in people with a first-ever stroke up to one year after discharge to the home setting differed based on three distinct movement behavior patterns, i.e., sedentary exercisers, sedentary movers and sedentary prolongers. Early identification of highly sedentary and inactive people with stroke after discharge to the home setting is important, as sedentary prolongers are at risk for restrictions in participation over time. Supporting people with stroke to adapt and maintain a healthy movement behavior after discharge to the home setting could prevent potential long-term restrictions in participation.</p
Oxidative stress leads to beta-cell dysfunction through loss of beta-cell identity
Pancreatic beta-cell failure is a critical event in the onset of both main types of diabetes mellitus but underlying mechanisms are not fully understood. beta-cells have low anti-oxidant capacity, making them more susceptible to oxidative stress. In type 1 diabetes (T1D), reactive oxygen species (ROS) are associated with pro-inflammatory conditions at the onset of the disease. Here, we investigated the effects of hydrogen peroxide-induced oxidative stress on human beta-cells. We show that primary human beta-cell function is decreased. This reduced function is associated with an ER stress response and the shuttling of FOXO1 to the nucleus. Furthermore, oxidative stress leads to loss of beta-cell maturity genes MAFA and PDX1, and to a concomitant increase in progenitor marker expression of SOX9 and HES1. Overall, we propose that oxidative stress-induced beta-cell failure may result from partial dedifferentiation. Targeting antioxidant mechanisms may preserve functional beta-cell mass in early stages of development of T1D.Nephrolog
Interleukin-5 and eosinophil cationic protein in nasal lavages of rhinitis patients
The production of interleukin-5 and eosinophil cationic protein (ECP) in the nasal cavity was examined in 24 patients with rhinitis who were allergic to the house dust mite. During a double-blind placebo-controlled cross-over study, fluticasone propionate aqueous nasal spray (200 μg) was administered twice daily for 2 weeks. After four basal nasal lavages provocation with house dust mite extract was performed and nasal lavages were collected every hour for 9.5 h. Interleukin-5 was present in detectable amounts in nasal lavages from patients allergic to house dust mite. Nasal challenge with house dust mite extract caused immediate nasal symptoms and increased levels of interleukin-5. Between 3.5 and 8.5 h after the challenge symptoms recurred and interleukin-5 levels increased, reflecting a late phase reaction. Eosinophil cationic protein, a marker of activated eosinophils, was released between 6.5 and 9.5 h after challenge. Treatment with fluticasone propionate (as an aqueous nasal spray) significantly decreased the evoked interleukin-5 and ECP levels in the late phase reaction. This response was correlated with an improved symptom score. This could indicate that the number and activity of eosinophils are increased during the late phase allergic reaction, a response that is inhibited by corticosteroids
Dietary patterns and changes in frailty status: the Rotterdam study
Purpose: To determine the associations between a priori and a posteriori derived dietary patterns and a general state of health, measured as the accumulation of deficits in a frailty index. Methods: Cross-sectional and longitudinal analysis embedded in the population-based Rotterdam Study (n = 2632) aged 45 years. Diet was assessed at baseline (year 2006) using food frequency questionnaires. Dietary patterns were defined a priori using an existing index reflecting adherence to national dietary guidelines and a posteriori using principal component analysis. A frailty index was composed of 38 health deficits and measured at baseline and follow-up (4 years later). Linear regression analyses were performed using adherence to each of the dietary patterns as exposure and the frailty index as outcome (all in Z-scores). Results: Adherence to the national dietary guidelines was associated with lower frailty at baseline (β −0.05, 95% CI −0.08, −0.02). Additionally, high adherence was associated with lower frailty scores over time (β −0.08, 95% CI −0.12, −0.04). The PCA revealed three dietary patterns that we named a “Traditional” pattern, high in legumes, eggs and savory snacks; a “Carnivore” pattern, high in meat and poultry; and a “Health Conscious” pattern, high in whole grain products, vegetables and fruit. In the cross-sectional analyses adherence to these patterns was not associated with frailty. However, adherence to the “Traditional” pattern was associated with less frailty over time (β −0.09, 95% CI −0.14, −0.05). Conclusion: No associations were found for adherence to a “healthy” pattern or “Carnivore” pattern. However, Even in a population that is relatively young and healthy, adherence to dietary guidelines or adherence to the Traditional pattern could help to prevent, delay or reverse frailty levels
- …